Insurance Claims Specialist
Workplace Details
Join our team and see why Prairie Lakes Healthcare System continues to be named a Top Rural and Community Hospital year after year. Be a part of our mission to make a positive difference in the health of the patients and communities we serve by delivering accessible, high-quality, affordable, and compassionate healthcare. Prairie Lakes Healthcare System is an independent, non-profit rural healthcare system serving 10 counties in northeastern South Dakota and west-central Minnesota.
Job Summary
This Full-Time on-site position performs the submission and follow-up of insurance claims for all service lines. Ensures billing procedures are followed to maximize cash and minimize accounts receivable.
Responsibilities include:
- Completes all edits to ensure claim submissions are compliant with federal and state regulations.
- Performs follow-up on insurance claims to obtain maximum payment in a timely manner.
- Administers timely and accurate billing and payment of all service lines
- Processes all secondary claims to seek reimbursement following primary insurance payment.
- Researches and resolves requests from insurance companies, patients, and third-party payors.
- Resolves billing problems and assists interdepartmentally with billing issues.
- Assists co-workers with problem resolution and team projects to decrease accounts receivable.
- Works with the patient account specialists on private pay accounts.
- Assists patients with insurance-related questions and problems.
- Completes monthly billing of reoccurring accounts (i.e. kidney dialysis, radiation, chemotherapy, home health, hospice, and physician).
- Other duties may be assigned.
Benefits
Prairie Lakes Healthcare System offers comprehensive benefits for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 403(b)-retirement plan, and generous paid time off to maintain a healthy home-work balance.
Additional benefits for those qualifying include:
- Flexible Spending Account
- Roth IRA retirement plan
- Employee Assistance Program for mental health
- Education Loan Program
- Community discounts including the Prairie Lakes Wellness Center
Qualifications
High school diploma or general education degree (GED); or equivalent combination of education and experience. One year prior medical or general office experience is preferred. Previous billing and computer experience is desirable.
Prairie Lakes Healthcare System has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.